Florida Department of Law Enforcement Agents Arrest South Florida Man in Scheme to Defraud Healthcare System

1/24/2008

Florida Department of Law Enforcement agents have arrested a South Florida man for his alleged role in a scheme in which a clinic billed for expensive HIV medications that were not necessary and, in many cases, were not given to patients.

Alexis M. Dagnesses, 43, of Miami, was arrested today at his residence and charged with one count of organized scheme to defraud, a violation of Florida State Statute 817.034 (4)(a)1. He was booked into the Turner Guilford Knight Detention Center in Miami.

The case, which began in the summer of 2005 and involved Miami clinics T&R Rehabilitation Professional Corp. and American Medical Applications (AMA), was investigated by FDLE agents, federal Health and Human Services and the Medicaid Fraud Control Unit. Attorney General Bill McCollum’s Office of Statewide Prosecution will prosecute the case.

Agents alleged that Dagnesses’ role in the scheme was to alter blood samples that had been taken from HIV patients so that the clinic could bill Medicare for expensive but unnecessary treatments for those patients.

Investigators believe that Dagnesses allegedly removed the patients’ blood samples from the clinic and then returned them after they had been altered. Once they were returned to the clinic, the samples were sent to a legitimate lab for analysis. In many of those cases, the altered samples came back showing very low platelet counts, which indicated the patients were sicker than they really were.

The patients whose altered platelet counts came back low were then told by the clinic that they needed certain medications to raise their platelet counts. The clinic then billed Medicare for the medications, which in some instances allegedly were administered in smaller doses than those billed or were not administered to the patients at all, agents said.

Investigators said that in some cases, when the patients were treated by different facilities and doctors not associated with the clinic, their platelet counts came back at higher levels.

For his alleged role in the scheme, which investigators said netted the clinic several million dollars from July 2003 to July 2005, Dagnesses allegedly received at least $50,000. Several other people connected to the clinic were arrested in March 2006 and September 2006.

For more information, contact:
Sandi Copes
Press Secretary
Office of the Attorney General
(850) 245-0150